I was recently diagnosed with stage 1 breast cancer. I am a 70-year-old woman, and it’s been 19 years since my menopause. Ten years ago my mom—who is in her 90s—developed breast cancer, but is doing well. Could you give me some information about possible risk factors and causes? Also, what about treatments?

Breast Cancer Diagnosis

By Peter N. Landless and Allan R. Handysides

I was recently diagnosed with stage 1 breast cancer. I am a 70-year-old woman, and it’s been 19 years since my menopause. Ten years ago my mom—who is in her 90s—developed breast cancer, but is doing well. Could you give me some information about possible risk factors and causes? Also, what about treatments?

Breast cancer has become more easily diagnosed in recent years because of the widespread use of mammography. Probably such sensing has contributed to the increased incidence of this form of cancer, and it’s being found at an earlier stage. Such early diagnosis has resulted in better outcomes. Indeed, some have questioned whether certain of the cancers being discovered require the same intensive treatment as more advanced cases.

In at least 75 percent of the cases of women who develop breast cancer, no risk factors are identifiable. Of the factors at work in the beginnings of breast cancer, some are more clear-cut than others.

Genetic predisposition is a factor in about 10 percent of cases, and involves the breast cancer genes 1 and 2 (BRCA1 and BRCA2), as well as a minor protein gene (TP53).

There also are some conditions that have a genetic basis, such as Cowden syndrome (PTEN gene), which are related to higher incidences of breast cancer.

Early onset of menarche, before the age of 12 years, is associated with a slight increase in breast cancer, while women who have a premature menopause, before age 30, have only half the risk compared to women entering menopause at age 55. Women taking estrogen and progesterone hormone-replacement therapy have about a 20 percent increased risk of breast cancer. Women taking estrogen alone, however, were not shown to have an increased breast cancer risk after seven years of follow-up in a National Institutes of Health (NIH) study.

Alcohol intake of a moderate amount appears to increase the risk of breast cancer, with increasing quantities of alcohol being associated with increased risk.

Diets high in animal fats also have been associated with increased risk of breast cancer. The problem is determining whether the risk is because of the fat or other possible carcinogens in such diets.

Obesity is associated with increased risk of breast cancer. A British study followed more than 1 million women, 50 to 64 years of age, from 1996 to 2001. In this study more than 45,000 new cancers were identified, with some 17,000 deaths occurring. This study noted an increased risk of breast cancer with increased body mass. Adjustments were made to account for the effects of body mass index, age, geographic location, smoking status, poverty, age of first birth, and the use of hormone-replacement therapy.

From this information we gather that being overweight, drinking alcohol, commencing menstruation early and finishing late, or taking estrogen and progesterone hormone-replacement therapy might well be operative factors in causing cancer. Genetic predisposition is a strong but less prevalent factor.

We will discuss treatment for breast cancer in the next issue of Adventist World.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General